1. Field of the Invention
The present invention relates to a tracheostomy apparatus and method to enable breathing when the upper portion of the throat is obstructed.
2. Description of the Prior Art
A number of devices have been advanced for performing non-dissection tracheostomies. Such devices are normally preferable to dissection tracheostomy procedures, which require considerable surgical skill in that the neck area is highly vascular, including many blood vessels which tend to bleed profusely during a dissection procedure.
U.S. Pat. No. 2,991,787, issued July 11, 1961 for "Tracheotomy Instrument" is typical of such devices. The device of that patent is essentially a cutting instrument, being characterized at its distal end by a plurality of blades which cut through the body tissues as the device is forced into the tracheal lumen. Consequently, its use if often accompanied by profuse bleeding. In addition, the device includes a leader which passes into the tracheal lumen in advance of the remainder of the device. This leader is sufficiently inflexible that, although it has a rounded end, it is susceptible to penetration of the tracheal wall and associated tissues such as the esophagus or large neck vessels.
My U.S. Pat. No. 3,511,243, issued May 12, 1970 for "Apparatus for Providing a Breathing Conduit Communicating with the Trachea at the Base of the Neck," discloses apparatus which meets some of the just-mentioned shortcomings of the prior art. The patent discloses a dilator having a relatively small cutting edge which projects laterally of the dilator body. Consequently there is considerable tissue dilation and a minimum of cutting, thereby achieving a greater tamponade effect, that is, a stopping of bleeding by pressure against the involved blood vessels. The apparatus of my patent utilizes a highly flexible leader separably attachable to the dilator. The flexibility of the leader eliminates the potential hazard of undesirably piercing the tracheal lumen wall and damaging adjacent tissues and organs. However, the apparatus and method for inserting the leader and subsequently removing it, and the sequence of procedural steps for locating the trachea tube in breathing position proved to be unnecessarily complicated, and the means for positively establishing proper location of the initially placed elements of the apparatus in the tracheal lumen were not completely satisfactory.